|
PR PHYS STANDBY SVC PROLNG PHYS ATTN EA 30 MINUTES
|
Professional
|
Both
|
$269.00
|
|
|
Service Code
|
HCPCS 99360
|
| Min. Negotiated Rate |
$60.51 |
| Max. Negotiated Rate |
$201.75 |
| Rate for Payer: Aetna Commercial |
$60.51
|
| Rate for Payer: BCBS Complete |
$107.60
|
| Rate for Payer: BCN Commercial |
$86.15
|
| Rate for Payer: Cash Price |
$215.20
|
| Rate for Payer: Cash Price |
$215.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$201.75
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$77.49
|
| Rate for Payer: Priority Health Narrow Network |
$77.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$87.67
|
| Rate for Payer: UHC Exchange |
$87.67
|
|
|
PR PINCH GRAFT 1/MLT SM ULCER TIP/OTH AR UP TO 2 CM
|
Professional
|
Both
|
$945.00
|
|
|
Service Code
|
HCPCS 15050
|
| Min. Negotiated Rate |
$273.28 |
| Max. Negotiated Rate |
$786.86 |
| Rate for Payer: Aetna Commercial |
$554.32
|
| Rate for Payer: Aetna Medicare |
$413.67
|
| Rate for Payer: BCBS Complete |
$286.94
|
| Rate for Payer: BCBS MAPPO |
$413.67
|
| Rate for Payer: BCN Commercial |
$694.69
|
| Rate for Payer: BCN Medicare Advantage |
$413.67
|
| Rate for Payer: Cash Price |
$756.00
|
| Rate for Payer: Cash Price |
$756.00
|
| Rate for Payer: Cofinity Commercial |
$595.68
|
| Rate for Payer: Cofinity Commercial |
$554.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$413.67
|
| Rate for Payer: Healthscope Commercial |
$496.40
|
| Rate for Payer: Healthscope Whirlpool |
$496.40
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$434.35
|
| Rate for Payer: Meridian Medicaid |
$286.94
|
| Rate for Payer: Molina Medicare/Medicaid |
$455.04
|
| Rate for Payer: Nomi Health Commercial |
$496.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$708.75
|
| Rate for Payer: PACE SWMI |
$413.67
|
| Rate for Payer: PHP Medicare Advantage |
$413.67
|
| Rate for Payer: Priority Health Choice Medicaid |
$273.28
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$635.81
|
| Rate for Payer: Priority Health Medicare |
$413.67
|
| Rate for Payer: Priority Health Narrow Network |
$635.81
|
| Rate for Payer: Railroad Medicare Medicare |
$413.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$786.86
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$413.67
|
| Rate for Payer: UHC Exchange |
$786.86
|
| Rate for Payer: UHC Medicaid |
$273.28
|
| Rate for Payer: UHCCP DNSP |
$413.67
|
| Rate for Payer: UHCCP Medicaid |
$273.28
|
|
|
PR PLACE CATH BRACHIAL ART
|
Professional
|
Both
|
$784.00
|
|
|
Service Code
|
HCPCS 36120
|
| Min. Negotiated Rate |
$313.60 |
| Max. Negotiated Rate |
$588.00 |
| Rate for Payer: BCBS Complete |
$313.60
|
| Rate for Payer: Cash Price |
$627.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$588.00
|
|
|
PR PLACE DRAIN PERIPANCREATIC ACUTE PANCREATITIS
|
Professional
|
Both
|
$3,381.00
|
|
|
Service Code
|
HCPCS 48000
|
| Min. Negotiated Rate |
$1,113.99 |
| Max. Negotiated Rate |
$3,435.46 |
| Rate for Payer: Aetna Commercial |
$2,338.98
|
| Rate for Payer: Aetna Medicare |
$1,745.51
|
| Rate for Payer: BCBS Complete |
$1,169.69
|
| Rate for Payer: BCBS MAPPO |
$1,745.51
|
| Rate for Payer: BCN Commercial |
$2,819.57
|
| Rate for Payer: BCN Medicare Advantage |
$1,745.51
|
| Rate for Payer: Cash Price |
$2,704.80
|
| Rate for Payer: Cash Price |
$2,704.80
|
| Rate for Payer: Cofinity Commercial |
$2,338.98
|
| Rate for Payer: Cofinity Commercial |
$2,513.53
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,745.51
|
| Rate for Payer: Healthscope Commercial |
$2,094.61
|
| Rate for Payer: Healthscope Whirlpool |
$2,094.61
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,832.79
|
| Rate for Payer: Meridian Medicaid |
$1,169.69
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,920.06
|
| Rate for Payer: Nomi Health Commercial |
$2,094.61
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,535.75
|
| Rate for Payer: PACE SWMI |
$1,745.51
|
| Rate for Payer: PHP Medicare Advantage |
$1,745.51
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,113.99
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$3,435.46
|
| Rate for Payer: Priority Health Medicare |
$1,745.51
|
| Rate for Payer: Priority Health Narrow Network |
$3,435.46
|
| Rate for Payer: Railroad Medicare Medicare |
$1,745.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,373.56
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,745.51
|
| Rate for Payer: UHC Exchange |
$3,373.56
|
| Rate for Payer: UHC Medicaid |
$1,113.99
|
| Rate for Payer: UHCCP DNSP |
$1,745.51
|
| Rate for Payer: UHCCP Medicaid |
$1,113.99
|
|
|
PR PLACEMENT CHOLEDOCHAL STENT
|
Professional
|
Both
|
$2,623.00
|
|
|
Service Code
|
HCPCS 47801
|
| Min. Negotiated Rate |
$661.79 |
| Max. Negotiated Rate |
$2,027.78 |
| Rate for Payer: Aetna Commercial |
$1,376.94
|
| Rate for Payer: Aetna Medicare |
$1,027.57
|
| Rate for Payer: BCBS Complete |
$694.88
|
| Rate for Payer: BCBS MAPPO |
$1,027.57
|
| Rate for Payer: BCN Commercial |
$1,664.25
|
| Rate for Payer: BCN Medicare Advantage |
$1,027.57
|
| Rate for Payer: Cash Price |
$2,098.40
|
| Rate for Payer: Cash Price |
$2,098.40
|
| Rate for Payer: Cofinity Commercial |
$1,479.70
|
| Rate for Payer: Cofinity Commercial |
$1,376.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,027.57
|
| Rate for Payer: Healthscope Commercial |
$1,233.08
|
| Rate for Payer: Healthscope Whirlpool |
$1,233.08
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,078.95
|
| Rate for Payer: Meridian Medicaid |
$694.88
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,130.33
|
| Rate for Payer: Nomi Health Commercial |
$1,233.08
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,967.25
|
| Rate for Payer: PACE SWMI |
$1,027.57
|
| Rate for Payer: PHP Medicare Advantage |
$1,027.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$661.79
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$2,027.78
|
| Rate for Payer: Priority Health Medicare |
$1,027.57
|
| Rate for Payer: Priority Health Narrow Network |
$2,027.78
|
| Rate for Payer: Railroad Medicare Medicare |
$1,027.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,985.06
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,027.57
|
| Rate for Payer: UHC Exchange |
$1,985.06
|
| Rate for Payer: UHC Medicaid |
$661.79
|
| Rate for Payer: UHCCP DNSP |
$1,027.57
|
| Rate for Payer: UHCCP Medicaid |
$661.79
|
|
|
PR PLACEMENT ENTEROSTOMY/CECOSTOMY TUBE OPEN
|
Professional
|
Both
|
$2,030.00
|
|
|
Service Code
|
HCPCS 44300
|
| Min. Negotiated Rate |
$507.79 |
| Max. Negotiated Rate |
$1,542.38 |
| Rate for Payer: Aetna Commercial |
$1,059.18
|
| Rate for Payer: Aetna Medicare |
$790.43
|
| Rate for Payer: BCBS Complete |
$533.18
|
| Rate for Payer: BCBS MAPPO |
$790.43
|
| Rate for Payer: BCN Commercial |
$1,265.87
|
| Rate for Payer: BCN Medicare Advantage |
$790.43
|
| Rate for Payer: Cash Price |
$1,624.00
|
| Rate for Payer: Cash Price |
$1,624.00
|
| Rate for Payer: Cofinity Commercial |
$1,138.22
|
| Rate for Payer: Cofinity Commercial |
$1,059.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$790.43
|
| Rate for Payer: Healthscope Commercial |
$948.52
|
| Rate for Payer: Healthscope Whirlpool |
$948.52
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$829.95
|
| Rate for Payer: Meridian Medicaid |
$533.18
|
| Rate for Payer: Molina Medicare/Medicaid |
$869.47
|
| Rate for Payer: Nomi Health Commercial |
$948.52
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,522.50
|
| Rate for Payer: PACE SWMI |
$790.43
|
| Rate for Payer: PHP Medicare Advantage |
$790.43
|
| Rate for Payer: Priority Health Choice Medicaid |
$507.79
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,542.38
|
| Rate for Payer: Priority Health Medicare |
$790.43
|
| Rate for Payer: Priority Health Narrow Network |
$1,542.38
|
| Rate for Payer: Railroad Medicare Medicare |
$790.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,500.51
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$790.43
|
| Rate for Payer: UHC Exchange |
$1,500.51
|
| Rate for Payer: UHC Medicaid |
$507.79
|
| Rate for Payer: UHCCP DNSP |
$790.43
|
| Rate for Payer: UHCCP Medicaid |
$507.79
|
|
|
PR PLACEMENT NEEDLE INTRAOSSEOUS INFUSION
|
Professional
|
Both
|
$582.00
|
|
|
Service Code
|
HCPCS 36680
|
| Min. Negotiated Rate |
$36.85 |
| Max. Negotiated Rate |
$436.50 |
| Rate for Payer: Aetna Commercial |
$77.48
|
| Rate for Payer: Aetna Medicare |
$57.82
|
| Rate for Payer: BCBS Complete |
$38.69
|
| Rate for Payer: BCBS MAPPO |
$57.82
|
| Rate for Payer: BCN Commercial |
$88.64
|
| Rate for Payer: BCN Medicare Advantage |
$57.82
|
| Rate for Payer: Cash Price |
$465.60
|
| Rate for Payer: Cash Price |
$465.60
|
| Rate for Payer: Cofinity Commercial |
$83.26
|
| Rate for Payer: Cofinity Commercial |
$77.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$57.82
|
| Rate for Payer: Healthscope Commercial |
$69.38
|
| Rate for Payer: Healthscope Whirlpool |
$69.38
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$60.71
|
| Rate for Payer: Meridian Medicaid |
$38.69
|
| Rate for Payer: Molina Medicare/Medicaid |
$63.60
|
| Rate for Payer: Nomi Health Commercial |
$69.38
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$436.50
|
| Rate for Payer: PACE SWMI |
$57.82
|
| Rate for Payer: PHP Medicare Advantage |
$57.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$36.85
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$95.33
|
| Rate for Payer: Priority Health Medicare |
$57.82
|
| Rate for Payer: Priority Health Narrow Network |
$95.33
|
| Rate for Payer: Railroad Medicare Medicare |
$57.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$107.60
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$57.82
|
| Rate for Payer: UHC Exchange |
$107.60
|
| Rate for Payer: UHC Medicaid |
$36.85
|
| Rate for Payer: UHCCP DNSP |
$57.82
|
| Rate for Payer: UHCCP Medicaid |
$36.85
|
|
|
PR PLACEMENT SETON
|
Professional
|
Both
|
$402.00
|
|
|
Service Code
|
HCPCS 46020
|
| Min. Negotiated Rate |
$70.72 |
| Max. Negotiated Rate |
$410.67 |
| Rate for Payer: Aetna Commercial |
$146.19
|
| Rate for Payer: Aetna Medicare |
$109.10
|
| Rate for Payer: BCBS Complete |
$74.26
|
| Rate for Payer: BCBS MAPPO |
$109.10
|
| Rate for Payer: BCN Commercial |
$175.79
|
| Rate for Payer: BCN Medicare Advantage |
$109.10
|
| Rate for Payer: Cash Price |
$321.60
|
| Rate for Payer: Cash Price |
$321.60
|
| Rate for Payer: Cofinity Commercial |
$157.10
|
| Rate for Payer: Cofinity Commercial |
$146.19
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$109.10
|
| Rate for Payer: Healthscope Commercial |
$130.92
|
| Rate for Payer: Healthscope Whirlpool |
$130.92
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$114.56
|
| Rate for Payer: Meridian Medicaid |
$74.26
|
| Rate for Payer: Molina Medicare/Medicaid |
$120.01
|
| Rate for Payer: Nomi Health Commercial |
$130.92
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$301.50
|
| Rate for Payer: PACE SWMI |
$109.10
|
| Rate for Payer: PHP Medicare Advantage |
$109.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$70.72
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$214.18
|
| Rate for Payer: Priority Health Medicare |
$109.10
|
| Rate for Payer: Priority Health Narrow Network |
$214.18
|
| Rate for Payer: Railroad Medicare Medicare |
$109.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$410.67
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$109.10
|
| Rate for Payer: UHC Exchange |
$410.67
|
| Rate for Payer: UHC Medicaid |
$70.72
|
| Rate for Payer: UHCCP DNSP |
$109.10
|
| Rate for Payer: UHCCP Medicaid |
$70.72
|
|
|
PR PLACEMENT XTN PROSTH FOR ENDOVASCULAR RPR
|
Professional
|
Both
|
$701.00
|
|
|
Service Code
|
HCPCS 34709
|
| Min. Negotiated Rate |
$184.03 |
| Max. Negotiated Rate |
$583.86 |
| Rate for Payer: Aetna Commercial |
$393.12
|
| Rate for Payer: Aetna Medicare |
$293.37
|
| Rate for Payer: BCBS Complete |
$193.23
|
| Rate for Payer: BCBS MAPPO |
$293.37
|
| Rate for Payer: BCN Commercial |
$468.10
|
| Rate for Payer: BCN Medicare Advantage |
$293.37
|
| Rate for Payer: Cash Price |
$560.80
|
| Rate for Payer: Cash Price |
$560.80
|
| Rate for Payer: Cofinity Commercial |
$393.12
|
| Rate for Payer: Cofinity Commercial |
$422.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$293.37
|
| Rate for Payer: Healthscope Commercial |
$352.04
|
| Rate for Payer: Healthscope Whirlpool |
$352.04
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$308.04
|
| Rate for Payer: Meridian Medicaid |
$193.23
|
| Rate for Payer: Molina Medicare/Medicaid |
$322.71
|
| Rate for Payer: Nomi Health Commercial |
$352.04
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$525.75
|
| Rate for Payer: PACE SWMI |
$293.37
|
| Rate for Payer: PHP Medicare Advantage |
$293.37
|
| Rate for Payer: Priority Health Choice Medicaid |
$184.03
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$503.39
|
| Rate for Payer: Priority Health Medicare |
$293.37
|
| Rate for Payer: Priority Health Narrow Network |
$503.39
|
| Rate for Payer: Railroad Medicare Medicare |
$293.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$583.86
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$293.37
|
| Rate for Payer: UHC Exchange |
$583.86
|
| Rate for Payer: UHC Medicaid |
$184.03
|
| Rate for Payer: UHCCP DNSP |
$293.37
|
| Rate for Payer: UHCCP Medicaid |
$184.03
|
|
|
PR PLACE NEEDLE/CATH A-V DIALYSIS SHUNT,1ST ACCESS W/ RAD EVAL
|
Professional
|
Both
|
$1,555.00
|
|
|
Service Code
|
HCPCS 36147
|
| Min. Negotiated Rate |
$622.00 |
| Max. Negotiated Rate |
$1,166.25 |
| Rate for Payer: BCBS Complete |
$622.00
|
| Rate for Payer: Cash Price |
$1,244.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,166.25
|
|
|
PR PLACE NEEDLE/CATH A-V DIALYSIS SHUNT,ADDL ACCESS FOR THERAPY
|
Professional
|
Both
|
$693.00
|
|
|
Service Code
|
HCPCS 36148
|
| Min. Negotiated Rate |
$277.20 |
| Max. Negotiated Rate |
$519.75 |
| Rate for Payer: BCBS Complete |
$277.20
|
| Rate for Payer: Cash Price |
$554.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$519.75
|
|
|
PR PLASTIC OPERATION PENIS INJURY
|
Professional
|
Both
|
$2,042.00
|
|
|
Service Code
|
HCPCS 54440
|
| Min. Negotiated Rate |
$711.74 |
| Max. Negotiated Rate |
$3,224.79 |
| Rate for Payer: Aetna Commercial |
$711.74
|
| Rate for Payer: BCBS Complete |
$777.06
|
| Rate for Payer: BCN Commercial |
$3,224.79
|
| Rate for Payer: Cash Price |
$1,633.60
|
| Rate for Payer: Cash Price |
$1,633.60
|
| Rate for Payer: Meridian Medicaid |
$777.06
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,531.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$740.06
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$915.14
|
| Rate for Payer: Priority Health Narrow Network |
$915.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,093.72
|
| Rate for Payer: UHC Exchange |
$2,093.72
|
| Rate for Payer: UHC Medicaid |
$740.06
|
| Rate for Payer: UHCCP Medicaid |
$740.06
|
|
|
PR PLASTIC REPAIR INTROITUS
|
Professional
|
Both
|
$926.00
|
|
|
Service Code
|
HCPCS 56800
|
| Min. Negotiated Rate |
$144.84 |
| Max. Negotiated Rate |
$694.50 |
| Rate for Payer: Aetna Commercial |
$299.17
|
| Rate for Payer: Aetna Medicare |
$223.26
|
| Rate for Payer: BCBS Complete |
$152.08
|
| Rate for Payer: BCBS MAPPO |
$223.26
|
| Rate for Payer: BCN Commercial |
$381.45
|
| Rate for Payer: BCN Medicare Advantage |
$223.26
|
| Rate for Payer: Cash Price |
$740.80
|
| Rate for Payer: Cash Price |
$740.80
|
| Rate for Payer: Cofinity Commercial |
$299.17
|
| Rate for Payer: Cofinity Commercial |
$321.49
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$223.26
|
| Rate for Payer: Healthscope Commercial |
$267.91
|
| Rate for Payer: Healthscope Whirlpool |
$267.91
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$234.42
|
| Rate for Payer: Meridian Medicaid |
$152.08
|
| Rate for Payer: Molina Medicare/Medicaid |
$245.59
|
| Rate for Payer: Nomi Health Commercial |
$267.91
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$694.50
|
| Rate for Payer: PACE SWMI |
$223.26
|
| Rate for Payer: PHP Medicare Advantage |
$223.26
|
| Rate for Payer: Priority Health Choice Medicaid |
$144.84
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$386.32
|
| Rate for Payer: Priority Health Medicare |
$223.26
|
| Rate for Payer: Priority Health Narrow Network |
$386.32
|
| Rate for Payer: Railroad Medicare Medicare |
$223.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$436.11
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$223.26
|
| Rate for Payer: UHC Exchange |
$436.11
|
| Rate for Payer: UHC Medicaid |
$144.84
|
| Rate for Payer: UHCCP DNSP |
$223.26
|
| Rate for Payer: UHCCP Medicaid |
$144.84
|
|
|
PR PLASTIC REPAIR URETHROCELE
|
Professional
|
Both
|
$833.00
|
|
|
Service Code
|
HCPCS 57230
|
| Min. Negotiated Rate |
$237.71 |
| Max. Negotiated Rate |
$719.73 |
| Rate for Payer: Aetna Commercial |
$490.39
|
| Rate for Payer: Aetna Medicare |
$365.96
|
| Rate for Payer: BCBS Complete |
$249.60
|
| Rate for Payer: BCBS MAPPO |
$365.96
|
| Rate for Payer: BCN Commercial |
$627.96
|
| Rate for Payer: BCN Medicare Advantage |
$365.96
|
| Rate for Payer: Cash Price |
$666.40
|
| Rate for Payer: Cash Price |
$666.40
|
| Rate for Payer: Cofinity Commercial |
$526.98
|
| Rate for Payer: Cofinity Commercial |
$490.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$365.96
|
| Rate for Payer: Healthscope Commercial |
$439.15
|
| Rate for Payer: Healthscope Whirlpool |
$439.15
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$384.26
|
| Rate for Payer: Meridian Medicaid |
$249.60
|
| Rate for Payer: Molina Medicare/Medicaid |
$402.56
|
| Rate for Payer: Nomi Health Commercial |
$439.15
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$624.75
|
| Rate for Payer: PACE SWMI |
$365.96
|
| Rate for Payer: PHP Medicare Advantage |
$365.96
|
| Rate for Payer: Priority Health Choice Medicaid |
$237.71
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$635.98
|
| Rate for Payer: Priority Health Medicare |
$365.96
|
| Rate for Payer: Priority Health Narrow Network |
$635.98
|
| Rate for Payer: Railroad Medicare Medicare |
$365.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$719.73
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$365.96
|
| Rate for Payer: UHC Exchange |
$719.73
|
| Rate for Payer: UHC Medicaid |
$237.71
|
| Rate for Payer: UHCCP DNSP |
$365.96
|
| Rate for Payer: UHCCP Medicaid |
$237.71
|
|
|
PR PLASTIC RPR PENIS CORRECT ANGULATION
|
Professional
|
Both
|
$3,915.00
|
|
|
Service Code
|
HCPCS 54360
|
| Min. Negotiated Rate |
$416.42 |
| Max. Negotiated Rate |
$2,936.25 |
| Rate for Payer: Aetna Commercial |
$862.96
|
| Rate for Payer: Aetna Medicare |
$644.00
|
| Rate for Payer: BCBS Complete |
$437.24
|
| Rate for Payer: BCBS MAPPO |
$644.00
|
| Rate for Payer: BCN Commercial |
$1,080.62
|
| Rate for Payer: BCN Medicare Advantage |
$644.00
|
| Rate for Payer: Cash Price |
$3,132.00
|
| Rate for Payer: Cash Price |
$3,132.00
|
| Rate for Payer: Cofinity Commercial |
$927.36
|
| Rate for Payer: Cofinity Commercial |
$862.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$644.00
|
| Rate for Payer: Healthscope Commercial |
$772.80
|
| Rate for Payer: Healthscope Whirlpool |
$772.80
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$676.20
|
| Rate for Payer: Meridian Medicaid |
$437.24
|
| Rate for Payer: Molina Medicare/Medicaid |
$708.40
|
| Rate for Payer: Nomi Health Commercial |
$772.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,936.25
|
| Rate for Payer: PACE SWMI |
$644.00
|
| Rate for Payer: PHP Medicare Advantage |
$644.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$416.42
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,177.15
|
| Rate for Payer: Priority Health Medicare |
$644.00
|
| Rate for Payer: Priority Health Narrow Network |
$1,177.15
|
| Rate for Payer: Railroad Medicare Medicare |
$644.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,272.20
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$644.00
|
| Rate for Payer: UHC Exchange |
$1,272.20
|
| Rate for Payer: UHC Medicaid |
$416.42
|
| Rate for Payer: UHCCP DNSP |
$644.00
|
| Rate for Payer: UHCCP Medicaid |
$416.42
|
|
|
PR PLASTICS COSMETIC CONSULT OFFICE VISIT
|
Professional
|
Both
|
$77.00
|
|
|
Hospital Revenue Code
|
990
|
| Min. Negotiated Rate |
$30.80 |
| Max. Negotiated Rate |
$57.75 |
| Rate for Payer: BCBS Complete |
$30.80
|
| Rate for Payer: Cash Price |
$61.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$57.75
|
|
|
PR PLASTICS COSMETIC FAT GRAFTING
|
Professional
|
Both
|
$2,575.00
|
|
|
Hospital Revenue Code
|
990
|
| Min. Negotiated Rate |
$1,030.00 |
| Max. Negotiated Rate |
$1,931.25 |
| Rate for Payer: BCBS Complete |
$1,030.00
|
| Rate for Payer: Cash Price |
$2,060.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,931.25
|
|
|
PR PLASTIC URETHRAL SPHINCTER VAGINAL APPROACH
|
Professional
|
Both
|
$1,130.00
|
|
|
Service Code
|
HCPCS 57220
|
| Min. Negotiated Rate |
$198.73 |
| Max. Negotiated Rate |
$847.50 |
| Rate for Payer: Aetna Commercial |
$407.51
|
| Rate for Payer: Aetna Medicare |
$304.11
|
| Rate for Payer: BCBS Complete |
$208.67
|
| Rate for Payer: BCBS MAPPO |
$304.11
|
| Rate for Payer: BCN Commercial |
$521.88
|
| Rate for Payer: BCN Medicare Advantage |
$304.11
|
| Rate for Payer: Cash Price |
$904.00
|
| Rate for Payer: Cash Price |
$904.00
|
| Rate for Payer: Cofinity Commercial |
$437.92
|
| Rate for Payer: Cofinity Commercial |
$407.51
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$304.11
|
| Rate for Payer: Healthscope Commercial |
$364.93
|
| Rate for Payer: Healthscope Whirlpool |
$364.93
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$319.32
|
| Rate for Payer: Meridian Medicaid |
$208.67
|
| Rate for Payer: Molina Medicare/Medicaid |
$334.52
|
| Rate for Payer: Nomi Health Commercial |
$364.93
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$847.50
|
| Rate for Payer: PACE SWMI |
$304.11
|
| Rate for Payer: PHP Medicare Advantage |
$304.11
|
| Rate for Payer: Priority Health Choice Medicaid |
$198.73
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$528.55
|
| Rate for Payer: Priority Health Medicare |
$304.11
|
| Rate for Payer: Priority Health Narrow Network |
$528.55
|
| Rate for Payer: Railroad Medicare Medicare |
$304.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$585.41
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$304.11
|
| Rate for Payer: UHC Exchange |
$585.41
|
| Rate for Payer: UHC Medicaid |
$198.73
|
| Rate for Payer: UHCCP DNSP |
$304.11
|
| Rate for Payer: UHCCP Medicaid |
$198.73
|
|
|
PR PLETHYSMOGRAPHY LUNG VOLUMES & AIRWAY RESISTANCE
|
Professional
|
Both
|
$105.00
|
|
|
Service Code
|
HCPCS 94726
|
| Min. Negotiated Rate |
$59.19 |
| Max. Negotiated Rate |
$85.23 |
| Rate for Payer: Aetna Commercial |
$79.31
|
| Rate for Payer: Aetna Commercial |
$79.31
|
| Rate for Payer: Aetna Medicare |
$59.19
|
| Rate for Payer: Aetna Medicare |
$59.19
|
| Rate for Payer: BCBS MAPPO |
$59.19
|
| Rate for Payer: BCBS MAPPO |
$59.19
|
| Rate for Payer: BCN Commercial |
$84.65
|
| Rate for Payer: BCN Commercial |
$84.65
|
| Rate for Payer: BCN Medicare Advantage |
$59.19
|
| Rate for Payer: BCN Medicare Advantage |
$59.19
|
| Rate for Payer: Cash Price |
$84.00
|
| Rate for Payer: Cash Price |
$23.20
|
| Rate for Payer: Cash Price |
$84.00
|
| Rate for Payer: Cash Price |
$23.20
|
| Rate for Payer: Cofinity Commercial |
$79.31
|
| Rate for Payer: Cofinity Commercial |
$85.23
|
| Rate for Payer: Cofinity Commercial |
$79.31
|
| Rate for Payer: Cofinity Commercial |
$85.23
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$59.19
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$59.19
|
| Rate for Payer: Healthscope Commercial |
$71.03
|
| Rate for Payer: Healthscope Commercial |
$71.03
|
| Rate for Payer: Healthscope Whirlpool |
$71.03
|
| Rate for Payer: Healthscope Whirlpool |
$71.03
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$62.15
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$62.15
|
| Rate for Payer: Molina Medicare/Medicaid |
$65.11
|
| Rate for Payer: Molina Medicare/Medicaid |
$65.11
|
| Rate for Payer: Nomi Health Commercial |
$71.03
|
| Rate for Payer: Nomi Health Commercial |
$71.03
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$21.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$78.75
|
| Rate for Payer: PACE SWMI |
$59.19
|
| Rate for Payer: PACE SWMI |
$59.19
|
| Rate for Payer: PHP Medicare Advantage |
$59.19
|
| Rate for Payer: PHP Medicare Advantage |
$59.19
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$78.07
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$78.07
|
| Rate for Payer: Priority Health Medicare |
$59.19
|
| Rate for Payer: Priority Health Medicare |
$59.19
|
| Rate for Payer: Priority Health Narrow Network |
$78.07
|
| Rate for Payer: Priority Health Narrow Network |
$78.07
|
| Rate for Payer: Railroad Medicare Medicare |
$59.19
|
| Rate for Payer: Railroad Medicare Medicare |
$59.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$81.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$81.66
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$59.19
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$59.19
|
| Rate for Payer: UHC Exchange |
$81.66
|
| Rate for Payer: UHC Exchange |
$81.66
|
| Rate for Payer: UHCCP DNSP |
$59.19
|
| Rate for Payer: UHCCP DNSP |
$59.19
|
|
|
PR PLEURAL SCARIFICATION REPEAT PNEUMOTHORAX
|
Professional
|
Both
|
$2,242.00
|
|
|
Service Code
|
HCPCS 32215
|
| Min. Negotiated Rate |
$499.70 |
| Max. Negotiated Rate |
$1,681.50 |
| Rate for Payer: Aetna Commercial |
$1,039.02
|
| Rate for Payer: Aetna Medicare |
$775.39
|
| Rate for Payer: BCBS Complete |
$524.68
|
| Rate for Payer: BCBS MAPPO |
$775.39
|
| Rate for Payer: BCN Commercial |
$1,195.65
|
| Rate for Payer: BCN Medicare Advantage |
$775.39
|
| Rate for Payer: Cash Price |
$1,793.60
|
| Rate for Payer: Cash Price |
$1,793.60
|
| Rate for Payer: Cofinity Commercial |
$1,116.56
|
| Rate for Payer: Cofinity Commercial |
$1,039.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$775.39
|
| Rate for Payer: Healthscope Commercial |
$930.47
|
| Rate for Payer: Healthscope Whirlpool |
$930.47
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$814.16
|
| Rate for Payer: Meridian Medicaid |
$524.68
|
| Rate for Payer: Molina Medicare/Medicaid |
$852.93
|
| Rate for Payer: Nomi Health Commercial |
$930.47
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,681.50
|
| Rate for Payer: PACE SWMI |
$775.39
|
| Rate for Payer: PHP Medicare Advantage |
$775.39
|
| Rate for Payer: Priority Health Choice Medicaid |
$499.70
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,125.95
|
| Rate for Payer: Priority Health Medicare |
$775.39
|
| Rate for Payer: Priority Health Narrow Network |
$1,125.95
|
| Rate for Payer: Railroad Medicare Medicare |
$775.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,407.80
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$775.39
|
| Rate for Payer: UHC Exchange |
$1,407.80
|
| Rate for Payer: UHC Medicaid |
$499.70
|
| Rate for Payer: UHCCP DNSP |
$775.39
|
| Rate for Payer: UHCCP Medicaid |
$499.70
|
|
|
PR PLEURECTOMY PARIETAL SEPARATE PROCEDURE
|
Professional
|
Both
|
$3,037.00
|
|
|
Service Code
|
HCPCS 32310
|
| Min. Negotiated Rate |
$567.22 |
| Max. Negotiated Rate |
$2,277.75 |
| Rate for Payer: Aetna Commercial |
$1,182.46
|
| Rate for Payer: Aetna Medicare |
$882.43
|
| Rate for Payer: BCBS Complete |
$595.58
|
| Rate for Payer: BCBS MAPPO |
$882.43
|
| Rate for Payer: BCN Commercial |
$1,365.96
|
| Rate for Payer: BCN Medicare Advantage |
$882.43
|
| Rate for Payer: Cash Price |
$2,429.60
|
| Rate for Payer: Cash Price |
$2,429.60
|
| Rate for Payer: Cofinity Commercial |
$1,270.70
|
| Rate for Payer: Cofinity Commercial |
$1,182.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$882.43
|
| Rate for Payer: Healthscope Commercial |
$1,058.92
|
| Rate for Payer: Healthscope Whirlpool |
$1,058.92
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$926.55
|
| Rate for Payer: Meridian Medicaid |
$595.58
|
| Rate for Payer: Molina Medicare/Medicaid |
$970.67
|
| Rate for Payer: Nomi Health Commercial |
$1,058.92
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,277.75
|
| Rate for Payer: PACE SWMI |
$882.43
|
| Rate for Payer: PHP Medicare Advantage |
$882.43
|
| Rate for Payer: Priority Health Choice Medicaid |
$567.22
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,286.32
|
| Rate for Payer: Priority Health Medicare |
$882.43
|
| Rate for Payer: Priority Health Narrow Network |
$1,286.32
|
| Rate for Payer: Railroad Medicare Medicare |
$882.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,613.21
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$882.43
|
| Rate for Payer: UHC Exchange |
$1,613.21
|
| Rate for Payer: UHC Medicaid |
$567.22
|
| Rate for Payer: UHCCP DNSP |
$882.43
|
| Rate for Payer: UHCCP Medicaid |
$567.22
|
|
|
PR PL GLYCOLIC 35/70
|
Professional
|
Both
|
$63.00
|
|
|
Hospital Revenue Code
|
990
|
| Min. Negotiated Rate |
$25.20 |
| Max. Negotiated Rate |
$47.25 |
| Rate for Payer: BCBS Complete |
$25.20
|
| Rate for Payer: Cash Price |
$50.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$47.25
|
|
|
PR PL ILLUMINIZE
|
Professional
|
Both
|
$84.00
|
|
|
Hospital Revenue Code
|
990
|
| Min. Negotiated Rate |
$33.60 |
| Max. Negotiated Rate |
$63.00 |
| Rate for Payer: BCBS Complete |
$33.60
|
| Rate for Payer: Cash Price |
$67.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$63.00
|
|
|
PR PL JESSNERS
|
Professional
|
Both
|
$63.00
|
|
|
Hospital Revenue Code
|
990
|
| Min. Negotiated Rate |
$25.20 |
| Max. Negotiated Rate |
$47.25 |
| Rate for Payer: BCBS Complete |
$25.20
|
| Rate for Payer: Cash Price |
$50.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$47.25
|
|
|
PR PLMT ACCESS THRU BILIARY TREE INTO SMALL BWL NEW
|
Professional
|
Both
|
$2,206.00
|
|
|
Service Code
|
HCPCS 47541
|
| Min. Negotiated Rate |
$187.23 |
| Max. Negotiated Rate |
$1,654.50 |
| Rate for Payer: Aetna Commercial |
$393.02
|
| Rate for Payer: Aetna Medicare |
$293.30
|
| Rate for Payer: BCBS Complete |
$196.59
|
| Rate for Payer: BCBS MAPPO |
$293.30
|
| Rate for Payer: BCN Commercial |
$489.01
|
| Rate for Payer: BCN Medicare Advantage |
$293.30
|
| Rate for Payer: Cash Price |
$1,764.80
|
| Rate for Payer: Cash Price |
$1,764.80
|
| Rate for Payer: Cofinity Commercial |
$422.35
|
| Rate for Payer: Cofinity Commercial |
$393.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$293.30
|
| Rate for Payer: Healthscope Commercial |
$351.96
|
| Rate for Payer: Healthscope Whirlpool |
$351.96
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$307.96
|
| Rate for Payer: Meridian Medicaid |
$196.59
|
| Rate for Payer: Molina Medicare/Medicaid |
$322.63
|
| Rate for Payer: Nomi Health Commercial |
$351.96
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,654.50
|
| Rate for Payer: PACE SWMI |
$293.30
|
| Rate for Payer: PHP Medicare Advantage |
$293.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$187.23
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$595.83
|
| Rate for Payer: Priority Health Medicare |
$293.30
|
| Rate for Payer: Priority Health Narrow Network |
$595.83
|
| Rate for Payer: Railroad Medicare Medicare |
$293.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$593.10
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$293.30
|
| Rate for Payer: UHC Exchange |
$593.10
|
| Rate for Payer: UHC Medicaid |
$187.23
|
| Rate for Payer: UHCCP DNSP |
$293.30
|
| Rate for Payer: UHCCP Medicaid |
$187.23
|
|
